BCACP Anticoagulation Management 3

Question 1

For a stable warfarin patient who has had three or more consecutive therapeutic INRs, what is the standard recommended monitoring frequency per ACCP guidelines?

Accepted Answer

Every 4 weeks (monthly)

Answer

ACCP guidelines support INR monitoring intervals up to 12 weeks for very stable patients, with monthly monitoring (every 4 weeks) being standard practice for most stable warfarin patients.

Question 2

How many days before a high-bleeding-risk elective surgical procedure should warfarin typically be held to allow the INR to normalize below 1.5?

Accepted Answer

5 days

Answer

Warfarin should be held for approximately 5 days before high-bleeding-risk surgery, corresponding to about 3–4 half-lives of warfarin (~36–42 hours), which is sufficient to normalize the INR.

Question 3

A patient on warfarin dramatically increases consumption of kale, spinach, and broccoli. What is the most likely effect on their INR?

Accepted Answer

INR will decrease due to increased vitamin K intake

Answer

Increased vitamin K intake from leafy greens enhances hepatic synthesis of vitamin K-dependent clotting factors, antagonizing warfarin and decreasing the INR.

Question 4

What is the minimum recommended duration of anticoagulation for a first provoked DVT associated with a reversible risk factor such as major surgery?

Accepted Answer

3 months

Answer

For a first provoked DVT triggered by a transient reversible risk factor (surgery, trauma, immobility), 3 months of anticoagulation is the guideline-recommended minimum duration.

Question 5

Which laboratory test is the standard monitoring parameter for unfractionated heparin (UFH) therapy?

Accepted Answer

aPTT (activated partial thromboplastin time)

Answer

The aPTT is the standard test for monitoring UFH therapy, with a therapeutic target of approximately 60–100 seconds (1.5–2.5 times the control value).

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP Anticoagulation Management 3